Kornimate/medical-research-clean huggingface dataset:
the effect of intravenous lactate on brain lactate concentrations during hypoglycemia

Conditions: Type 1 Diabetes Mellitus With Hypoglycemia

Summary: patients with type 1 diabetes (t1dm) who are unable to perceive symptoms of hypoglycemia, referred to as impaired awareness of hypoglycemia (iah), are at very high risk of severe hypoglycemia. iah affects approximately 25% of patients with t1dm. brain lactate may be involved in the development of iah. a recent study indicated increased brain lactate utilization during hypoglycemia in t1dm patients with iah, which did not occur in patients with normal awareness of hypoglycemia (nah). conversely, administration of lactate to patients with nah has been shown to attenuate counterregulatory hormone responses to and symptomatic awareness of hypoglycemia, thus causing a situation that resembles iah. it has, however, not been demonstrated whether the excess of lactate is actually taken up or metabolized by the brain, and if so whether this occurs under euglycemic or hypoglycemic conditions or both. this project consists of two related studies. the objective of part 1 is to investigate the effect of elevated plasma lactate levels that are sufficient to impair awareness of hypoglycemia on brain lactate concentrations during euglycemia and hypoglycemia in t1dm patients with nah. the objective of part 2 is to compare the effect of exogenous lactate on brain lactate concentrations between t1dm patients with nah and t1dm patients with iah. furthermore, this study aims to determine the effect of acute hypoglycemia on the inflammatory function and composition of peripheral blood mononuclear cells.


Eligibility criteria:
inclusion criteria: * diabetes duration ≥ 1 year * age: 18-50 years * body-mass index: 18-30 kg/m2 * hba1c: 42-75 mmol/mol (6-9%) * outcome clarke questionnaire: 0-1 or \>=3 * blood pressure: \<160/90 mmhg exclusion criteria: * inability to provide informed consent * use medication other than insulin, except for oral contraceptives or stable thyroxin supplementation therapy * presence of any other medical condition that might interfere with the study protocol, such as brain injuries, epilepsy, a major cardiovascular disease event, known liver disease, anxiety disorders or a history of panic attacks. * microvascular complications of t1dm: proliferative retinopathy, symptomatic diabetic neuropathy (including autonomic neuropathy), nephropathy; clinical/overt albuminuria or an estimated glomerular filtration rate \<60ml/min/1.73m2 * mr(i) contraindications (pregnancy, severe claustrophobia, metal parts in body)

Keywords: type 1 diabetes mellitus impaired awareness of hypoglycemia lactate mr spectroscopy
perioperative risk factors related to the prognosis of lung transplantation: a retrospective study

Conditions: COPD; Interstitial Pneumonia; Bronchiectasis; Respiratory Failure; Idiopathic Pulmonary Fibrosis (IPF); Silicosis; Pulmonary Tuberculosis; Pulmonary Hypertension; Pulmonary Heart Disease

Summary: this study analyzes patients who underwent lung transplantation at the first affiliated hospital of zhejiang university from 2017 to 2024, focusing on anesthesia's impact on post-op results. it gathers patient data from hospital and mediston systems, with main focus on in-hospital complications and secondary focus on icu stay, post-op hospitalization, mortality, and intubation time. the research aims to deepen understanding of anesthetic management's role in lung transplant outcomes and guide improvements in perioperative anesthesia protocols.


Eligibility criteria:
inclusion criteria: * age \>18 years at time of transplantation * received single or bilateral lung transplantation exclusion criteria: * re-transplantation * multi-organ transplantation * autotransplantation * incomplete medical records: recipients with \>20% missing essential data elements in any of these categories:preoperative baseline characteristics； intraoperative parameters；postoperative outcome measures

Keywords: lung transplantatipn perioperative-related risks mortality in-hospital complications prognosis
effect of pain control on the diagnosis of acute appendicitis on the diagnostic accuracy of general surgeon

Conditions: Appendicitis

Summary: the pain control in surgical abdomen has been in debate in masking the correct diagnosis. we would like to investigate the effect of pain control on the diagnostic accuracy of surgeon in suspicious appendicitis patients. we would give morphine or placebo to the patients suspected of appendicitis randomly and in double-blinded manner, and then surgeons would exam the patient and give the impression for the possibility of the appendicitis(grading 1 to 4). with this grading, we compare these impression between two groups.


Eligibility criteria:
inclusion criteria: * the patients suspected of acute appendicitis over 15 years exclusion criteria: * less than 15 years * pregnant * allergic to morphine * systolic blood pressure\<100mmhg * received pain killer prior to ed visit * do not consent

Keywords: appendicitis diagnosis
group-based metacognitive therapy for burns and plastics patients

Conditions: Anxiety; Low Mood

Summary: serious burns and other traumatic or disfiguring injuries represent a significant public health burden. survivors often need intense medical or surgical treatment, including plastic surgery. as well as devastating physical injuries, up to 45% of people develop significant mental health difficulties following a traumatic injury. these difficulties include depression, anxiety and post-traumatic stress disorder (ptsd). cognitive behavioural therapy (cbt) is the most widely offered treatment within the national health service (nhs) and the most common treatment provided for burns and plastics patients. however, cbt is limited in efficacy, time-consuming, and focuses on treating the most distressing problem first. one way to overcome these limitations is to evaluate a group therapy that can treat multiple mental health problems at once. one such treatment is called metacognitive therapy (mct; wells 2009). mct targets metacognitive beliefs (beliefs people hold about their thinking) rather than the content of patients' thoughts (i.e. reality testing), which is advantageous over cognitive therapies as often following a burns or plastics injury patients experience realistic negative thoughts (e.g. thoughts about disfigurement). mct has been shown to be more effective at treating anxiety and depression in mental health settings than cbt, however, more research is needed to evaluate mct in physical health settings. the aim of this study is to examine the acceptability and feasibility of group-mct within the department of burns, plastics and reconstructive surgery at wythenshawe hospital. we aim to recruit 20 patients to receive six weekly sessions of group-mct. sessions will last approximately 90 minutes. indicators of feasibility and acceptability will be described including rates of referrals, recruitment, and dropout. data on symptom outcomes (as measured by the phq-9 and gad-7) at pre and post treatment will be assessed and benchmarked against usual treatment delivered. the data will be used to inform a future large-scale trial on the effectiveness of mct.


Eligibility criteria:
inclusion criteria: * outpatients at the adult burns centre in wythenshawe hospital; * age 18 or older; * at least one month since the occurrence of the injury; * a competent level of english language skills (able to read, understand and complete questionnaires in english). * in the event that sessions will be conducted remotely, participants will require adequate internet connection and access to microsoft teams/zoom. exclusion criteria: * cognitive impairment which precludes informed consent or ability to participate; * acute suicidality; * active psychotic disorders; * current drug or alcohol abuse; * individuals engaging in active deliberate self-harm; * dementia or learning difficulties; * antidepressant or anxiolytic medications initiated in the previous 8 weeks; * individuals who intentionally set themselves on fire.
examining the feasibility and acceptability of a tailored version of a mindfulness-based intervention (mbi) among youth experiencing homelessness (yeh)

Conditions: Stress, Emotional

Summary: a mindfulness-based intervention (mbi), called ".b," will be tailored to youth experiencing homelessness (yeh) by using focus group discussions, key informant interviews, and iterative beta-testing with the homeless youth working group (hywg). the purpose of this study is to assess the feasibility and acceptability of this tailored mbi in yeh (the tailored mbi called .b will be compared to an attention control condition). the results of this feasibility study will inform the design of a future randomized controlled trial that will aim to test the efficacy of the intervention for improving stress management, increasing emotional regulation, decreasing impulsivity in yeh.


Eligibility criteria:
inclusion criteria for youth participants: * homeless youth receiving services at one of the recruitment sites in houston, texas area at the time of enrollment * english speaking * able to participate for the entire study period (i.e., not moving during the study) inclusion criteria for service providers: * currently providing health or social services to yeh * interested in participating in an interview or as a member of the expert advisory panel exclusion criteria for youth participants: * overtly exhibiting symptoms of severe, untreated mental illness criteria * not staying at the shelter * currently experiencing homelessness or unstable housing exclusion criteria for service providers: -not able to meet for the regularly scheduled meetings at least 75% of the time.
comorbidities and outcomes in early rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: identify the burden of comorbidity at the time of diagnosis of rheumatoid arthritis. identify the impact of comorbidity present at diagnosis on cardiovascular disease, death, rheumatoid arthritis disease progression and infections.


Eligibility criteria:
inclusion criteria: * diagnosis of rheumatoid arthritis prior to 1st january 2017 * aged ≥18 years old exclusion criteria: * patients with another other rheumatic disease
quantitative and qualitative research for "mhealth program to support people living with hiv across the hiv care continuum"

Conditions: HIV Infections

Summary: the goal of this randomized control trial (rct) is to assess the effectiveness of amp, a mobile health (mhealth) app designed to improve outcomes along the hiv care continuum for young black men who have sex with men (ybmsm) living with hiv. hiv care continuum (linkage to care, retention, viral suppression), quality of life and self efficacy outcomes will be compared after a 4-month period between the intervention group (use amp and standard of care) and the control group (standard of care only).

a maximum of 400 ybmsm participants will be recruited into a randomized control trial from multiple sites across the us to assess the effectiveness of amp, an mhealth app designed to improve outcomes along the hiv care continuum for ybmsm living with hiv. hiv care continuum (linkage to care, retention, viral suppression), quality of life and self efficacy outcomes will be compared after a 4-month period between the intervention group (use amp and standard of care) and the control group (standard of care only).

Eligibility criteria:
inclusion criteria: * msm and; * black or african-american and; * 18-29 years old and; * diagnosed with hiv during the study period (from april 1, 2024-august 31 2024) or; * diagnosed with hiv in the year prior to the study period (april 1, 2023-march 31, 2024) or; * hiv positive but not linked into care or; * fallen out of care (no hiv care visits within last 6 months) or; * currently in care but not virally suppressed (viral load ≥200 copies/ml) * and, online access through a mobile device and; * ability to read and write english. exclusion criteria: * currently participating in another hiv care continuum or mobile health intervention * plan to leave the study site within the study period * cognitively impaired at recruitment or baseline testing * has a self-reported health issue that prohibits them from participating

Keywords: hiv mhealth viral load hiv disparities hiv care continuum
prevention and treatment of laryngospasm and hypoxemia based on risk factors in adult outpatients undergoing egd

Conditions: Laryngospasm; Hypoxemia

Summary: the purpose of this study is to identify patient and provider-chosen factors that put patients at risk for the development of hypoxemia (oxygen saturation \< 90% for 5 seconds) during endoscopy and to use this knowledge to develop a treatment protocol for specific causes of hypoxemia in adult esophagogastroduodenoscopy outpatients.


Eligibility criteria:
inclusion criteria: * over the age of 18 years * english speaking * mentally competent to sign their own consent for treatment exclusion criteria: * poor incisor teeth stability * anticipated procedure of greater than 30 minutes * history of facial or oral surgery and a baseline oxygen saturation of less than 95% on room air
spectral domain optical coherence tomography analysis for glaucoma

Conditions: GLAUCOMA 1, OPEN ANGLE, D (Disorder)

Summary: the aim of this study is to examine whether there is a difference in macular ganglion cell complex thickness and retinal nerve fiber layer thickness in early-stage primary open angle glaucoma and normal tension glaucoma with spectral domain oct.

glaucoma is a progressive optic neuropathy characterized by gradual degeneration of neuronal tissue in which retinal ganglion cells (rgcs) are injured, leading to the loss of the visual field.recent studies have separately demonstrated a reduction in the macular retinal thickness and in the retinal nerve fibers in both poag and ntg.it has been demonstrated that in early stage ntg macular gcc thickness showed a strong correlation with thickness of the rnfl. however there have yet to be any reports regarding the comparison of macular thickness, ganglion cell complex and retinal nerve fiber layer between poag and ntg with rs-3000 retinascan at early stage.

Eligibility criteria:
inclusion criteria: the poag group inclusion criteria were; * iop higher than 21 mmhg before treatment on three different visits, * best corrected va of 20/25 or better with a spherical equivalent within ±5 d and a cylinder correction within +3 d; * an open angle confirmed by gonioscopy. * glaucomatous optic disc damage defined as by the presence of glaucomatous optic neuropathy like rim thinning (diffuse or local), cupping, notching, and a cup/disc ratio \>0.2 with asymmetry. ntg group were included if; • they had the same optic disc and visual field criteria as for the poag patients with the exception that their iop was as ≤21 mmhg on three separate visits without any glaucomatous treatment. the control group * who had no ocular disease * who had not undergone ocular surgery or laser procedures. * with a normal anterior segment, open angles, and normal posterior segment findings also normal optic nerve head appearance in their ophthalmic examination. * the iop measurements were lower than 21 mmhg, and full-threshold 30-2 hfa were also within normal limits in the control group. exclusion criteria: * subjects with any retinal disease, diabetes mellitus, or neurological disease or who had undergone ocular surgery and laser procedures. * subjects with pseudoexfoliation glaucoma and pigmentary glaucoma were excluded.

Keywords: ganglion cell complex, retinal nerve fiber layer,glaucoma
ozurdex for diabetic macular edema treated with pars plana vitrectomy and membrane removal (opera study)

Conditions: Diabetic Macular Edema; Epiretinal Membrane

Summary: this study will examine the use of the dexamethasone implant (ozurdex) in patients with macular edema associated with an epiretinal or preretinal membrane requiring surgical intervention. after the surgery is performed (pars plana vitrectomy), an ozurdex implant will be placed in the eye. patients will be followed for 1 year.

the purpose of this study to examine the use of ozurdex in patients who are undergoing pars plana vitrectomy for macular edema due to preretinal membranes. specifically, we will examine its effect on macular edema (measured by oct), and visual recovery (measured by visual acuity). we will examine its use in patients who underwent pars plana vitrectomy for macular edema with associated taut membrane. this will be a prospective pilot study with patients to receive an ozurdex implant at the time of vitrectomy.

Eligibility criteria:
inclusion criteria: 1. patients who are undergoing pars plana vitrectomy for: * epiretinal membrane/vitreomacular traction or * diabetic macular edema 2. patients with macular edema as measured by oct (at least 250 um central subfoveal thickness) 3. informed consent requirements: all study subjects must agree to participate in the study and provide written informed consent, which will be written in english. 4. age between 18-85 years old exclusion criteria: 1. age \ 85 years 2. history of macular edema due to diseases other than those in the inclusion criteria in the study eye * history of active inflammatory eye disease (uveitis) (within 3 months) * history of ocular malignancy and/or ocular/orbital irradiation * history of recent retinal vein occlusion (within 6 months) * history of neovascular age-related macular degeneration or choroidal neovascular membrane \[ * history of juxtafoveal telangiectasia * history of coat's disease * history central serous choroidoretinopathy * history of previous infectious retinitis (toxoplasmosis, acute retinal necrosis, tuberculosis, etc) 3. patients with a history of intraocular infection in the study eye (i.e. viral retinitis, endophthalmitis) 4. patients who are cognitively impaired or those who are unable to provide informed written consent 5. patients with a history of glaucoma in the study eye (defined as increased cup to disc ratio with associated nerve damage. patients with ocular hypertension controlled by topical glaucoma drops (maximum 3) will not be excluded). 6. patient with recent intravitreal injections of steroids or anti-vegf medications in the study eye (within past 4 weeks). 7. patients with recent periocular steroid injection (within past 4 weeks) in the study eye 8. patients on topical nsaids drops (patient will be eligible if they discontinue use of topical nsaids at time of study enrollment) in the study eye

Keywords: diabetes macular edema epiretinal membrane vitrectomy
lifestyle in turkish-background diabetics

Conditions: Diabetes Mellitus

Summary: background: life-style interventions are indicated in patients with metabolic syndrome and/or type 2 diabetes. however, cultural differences are substantial confounders to not only compliance, but also whether or not the interventions are offered in the first place. in germany, the large turkish-background minority has a particularly high incidence of type 2 diabetes, but there is no recorded evidence of a life-style intervention in this patient group. objective: the investigators tested the body weight-reducing effect of a 30% calorie-reduced diet, adjusted to individual eating habits and preferences regarding quality and resources of food in a turkish-background cohort.

the investigators conducted a prospective, randomized, two-arm parallel study. in both arms, patients were instructed in a 12-week diet that was reduced by in caloric content by at least 30% based on calorimetric measurements of 24 h resting energy expenditure and estimated additional expenditures by diet- and activity-induced thermogenesis. before and after the diet, anthropometric measures and various mets-associated blood parameters were determined. the subjects were not instructed in an exercise program. however, the subjects were advised on the value of increased physical activity. for additional motivation, effects were tested by an activity monitor. therefore, in one of the arms, 24 hour locomotor activity and energy expenditure were determined by means of the sensewear® mf armband (body media inc., aliphcom dba jawbone®, pittsburgh, pa, u.s.a.). this device detects activity contest using accelerometers and assesses daily energy expenditure. for allocation of the subjects, a computer-generated list of random numbers was used. the randomization sequence was created using spss 18 (spss, inc., chicago, il, usa) statistical software and subjects were assigned to be tested or not for locomotor activity with a 1:1 allocation using random block sizes of 2, 4, and 6.

Eligibility criteria:
inclusion criteria: * age 30 - 65 years * bmi 30 - 40 kg/m2 * non-insulin dependent diabetes exclusion criteria: * pregnancy * more than 3 anti-diabetic drugs
disease activity biomarkers in patients with systemic lupus erythematosus

Conditions: Lupus Nephritis

Summary: the aim of this research project is to better understand the origin and clinical significance of two lupus-specific "genetic signatures" (ifn signature and plasma cell signature) in patient subgroups with well-defined clinical characteristics. our aim is to correlate these genetic signatures with cell activation profiles and the production of specific cytokines in different populations from whole blood and in short-term cultures of these circulating cells.

the aim of the experiment is, on the one hand, to identify and study the different cell populations from whole blood by flow cytometry and, on the other hand, to assay different cytokines in blood and urine samples from diseased (sle) and control subjects (with non-inflammatory rheumatic diseases) in order to highlight and correlate the presence of biomarkers to disease activity or to a clinical manifestation of the disease. in vitro studies will also be carried out on short-term cultures of pbmcs (peripheral blood mononuclear cells).

Eligibility criteria:
inclusion criteria: * fulfilment of the eular/acr classification criteria of sle. * 18 years of age or above. * incident or flare biopsy-proven proliferative or membranous ln exclusion criteria: * antiphospholipid syndrome nephropathy (apsn). * pregnancy at baseline (pregnancy during follow-up will not lead to exclusion). * anticipated non-adherence to therapy. * medical conditions interfering with outcome evaluations. * inability to read and/or sign the informed consent form.